Resources and Education

We believe that the best patient is an educated patient. Don’t wait for bad news to come when you least expect it. At Denver Health, we want our patients to become advocates for better health.

It starts with being proactive about patient education. As a central player in a growing urban community, health information is a top priority for us — especially for issues that fall outside of everyone’s control. That’s why we advocate for ways to reduce your risk of developing diseases of the liver and digestive tract.

 

Endoscopy Lab Coordinator

Jenn Dozier  assists patients with access to services, coordinates care and procedures, and provides community resources. Please call her for information or education at 303-602-4468 and 720-392-5392.

 

Procedure Based Education

Colonoscopy 1-Day Prep

Colonoscopy Prep Sheets

Colonoscopy 2-Day Prep

Flexible Sigmoidoscopy Prep

Flexible Sigmoidoscopy Prep Sheets

Getting Ready for the Capsule Procedure

Getting Ready for Your Endoscopic Ultra Sound (EUS)

Getting Ready for Your Upper Endoscopy

Sedation

Monitored Anesthesia Care, Care After

 

Adult Moderate Conscious Sedation

Getting Ready for Your Endoscopic Retrograde Cholangiopancreatography (ERCP)

Endoscopy Procedure Types

The following procedures are offered at the Denver Health Gl Lab.

Flexible sigmoidoscopy may be performed occasionally without sedating medication. EGO, colonoscopy, and PEG tube placement typically require the use of sedating medications such as intravenous Fentanyl or Midazolam. Small bowel enteroscopy, EUS, and ERCP generally require deeper sedation with intravenous Diprivan or general anesthesia.

Flexible sigmoidoscopy and colonoscopy require that the patient follow a strict clear-liquid type diet for 24 hours prior to the exam and that he/she drinks an  4-liter laxative bowel prep the night before the exam.

Esophagastroduodenoscopy (EGD)- During EGD or upper endoscopy, the gastroenterologist inserts a flexible, lighted camera tube into the mouth and through  the upper Gl tract. The esophagus, stomach, and top part of the small intestine are examined and photographs are taken. Depending on the findings, the physician may then perform  one of several interventions such as sampling tissue, cauterizing blood vessels, opening up a narrowed section of the gut (stenosis) with a balloon or cone dilator,removing foreign bodies, or placing rubber bands around bleeding lesions. EGD is used in the diagnosis and management of esophageal disorders, acid reflux, peptic ulcers, Gl tumors, bleeding lesions, and foreign body ingestion.

Colonoscopy- During colonoscopy the gastroenterologist inserts a flexible, lighted camera tube into the anus and through the entire colon (large intestine). The colon and a small portion of the small intestine {ileum) are examined and photographs are taken. Depending on the findings, the physician may then perform one of several interventions such as removing precancerous growths (polyps), sampling tissue, cauterizing blood vessels, opening up a narrowed section of the gut (stenosis) with a balloon or cone dilator, or removing foreign bodies. Colonoscopy is used for the diagnosis and treatment of colon disorders such as polyps, inflammatory bowel disease, bleeding lesions, colon cancer, and other types of obstruction.

Flexible sigmoidoscopy (Fiex-sig)- A flex-sig is similar to a colonoscopy except that only the lower (left) half of the colon is examined. Flex-sig requires a full bowel prep but is generally quicker and safer than colonoscopy and may sometimes be performed with minimal or no sedation. Flex-sig is used for the diagnosis and treatment of disorders located in the lower part of the colon.

Percutaneous endoscopic gastrostomy (PEG) tube placement
- During PEG tube placement,an upper endoscopy is performed. The gastroenterologist then makes a small incision in the abdominal skin and inserts a plastic feeding (PEG) tube through this incision and across the abdominal wall into the stomach. The tube.is secured inside the stomach with a plastic button. The tube can then be used for feeding the patient with a liquid formula. PEG tubes are most commonly used for those patients who are unable to swallow because of stroke or other neurologic disease,blockage or impaired function of the throat  or esophagus, or severe malnutrition.

Video capsule endoscopy (VCE)- During VCE, a camera pill is ingested by the patient or inserted into the stomach by the physician. The pill is activated and takes multiple ultra-rapid photographs over the next 10-12 hours until it runs out of power. As the pill passes through the entire Gl tract,it takes pictures of the stomach, small intestine, and colon. During this time the patient wears a recording harness that receives copies of the photographs taken by the pill. The harness is then returned to the Gllab,where images can be downloaded, reviewed, and interpreted by the gastroenterologist. The powerless pill passes out of the patient via the stool and is not retrieved. VCE is used for diagnosing small bowel disorders such as Crohn's disease, bleeding lesions, and tumors.

Small bowel enteroscopy (SBE)- This is similar to EGD but the gastroenterologist uses a longer camera and examines more of the small intestine.  A long endoscope is inserted into the mouth and through the esophagus, stomach;and small intestine. This exam typically allows the physician to examine approximately 2 feet of small intestine including the duodenum (top part) and part of the jejunum (middle part). SBE is used for the diagnosis and treatment of small bowel disorders such as Crohn's disease,bleeding lesions, and tumors.

Endoscopic Ultrasound (EUS)- During EUS the gastroenterologist inserts a flexible, lighted camera tube with an attached ultrasound probe through the mouth or anus and into the small intestine or rectum. The ultrasound probe is then used to evaluate various digestive disorders. Among other indications, EUS is used to diagnose and stage tumors of the esophagus, stomach, small intestine,pancreas,bile duct,and rectum with greater accuracy than standard CT or MRI. EUS also assists in managing various disorders such as pancreatitis, pancreatic cysts, gallstones, and fecal incontinence. EUS allows for sampling of Gland pancreatic tumors, cysts,and lymph nodes. It may also be used for drainage of pancreatic pseudocysts or gaining access to obstructed ducts or organs.

Endoscopic Retrograde Cholangiopancreatography (ERCP)- During ERCP the gastroenterologist inserts a specialized, flexible,lighted camera tube through the mouth and into the small intestine. The tip of the endoscope is then placed next to the opening of the bile and pancreatic ducts. A catheter is then inserted either into one or both ducts and contrast dye is injected. Live X-ray pictures are taken during contrast injection in order to diagnose various disorders. Depending on the findings or the condition, the physician may then take tissue samples, make an incision to open up the ducts, place a stent, or remove gallstones or small tumors. A miniature endoscope may also be inserted into the bile duct (cholangioscopy) or pancreatic duct (pancreatoscopy) and can be used to diagnose certain tumors or assist with stone removal.

Intraluminal stent placement- During upper endoscopy or colonoscopy, a metal stent may be inserted into the intestine across a blockage caused by tumor or diseases. The stent may be left in indefinitely or removed at a later date depending on the patient's symptoms or the underlying condition.

Endoscopic mucosal resection (EMR)- EMR refers to the removal of large polyps, early cancers, or other lesions from the esophagus, stomach,small intestine, or colon. EMR requires special training and equipment and hence is only performed by select gastroenterologists.

Diagnostic and Therapeutic Procedures

Besides colonoscopies and upper endoscopies, Denver Health is able to provide the latest diagnostic and interventional procedures. Capsule endoscopy, a video camera contained in a capsule small enough to swallow, allows visualization of the entire small intestine. Advanced biliary and pancreatic endoscopy provides diagnosis and treatment for patients with stones or strictures in the bile or pancreatic ducts.
  • Endoscopic ultrasound - Endoscopic ultrasound allows diagnosis and staging of tumors with much greater accuracy than standard CT scans or MRI in many cases.
  • Endoscopic retrograde cholagio pancreatogram (ERCP) - After the endoscope is inserted through the mouth and into the bile duct, dye is squirted through the endoscope and into the bile duct. X-ray pictures are taken, and the dye helps to highlight any abnormal areas. Biopsy samples and fluid can also be taken during the ERCP.
  • Liver biopsy - Patients are usually referred for liver biopsy from the Hepatology clinic. The procedure involves removing some tissue from the liver to be looked at under a microscope.

Whatever digestive or liver concerns you might have, the professionals in Denver Health’s Division of Digestive and Liver Health are ready to provide level one care for you.